The numbers account for around a fifth of the workforce, as the trust struggles to save £75 million.

There are fears that the staffing reductions could lead to increased waiting times, closed wards and reduced services.

Union officials said the losses would 'inevitably' affect the level of patient care.

Tim Ellis, from Unison, said: "This kind of reduction must put real pressure on patient care and access to services. We've already seen a reduction of 60 front line staff at East Lancashire Trust this year.

"Positions which are classed as administrative, such as medical secretaries, are key. They run consultants lives. If support goes in one area, another member of staff can't do their job – it's all interconnected. There has to come a point where the trust says it can't carry on like this."

Hospital chiefs said the majority of staff reductions would be in 'non-clinical' posts and that there are currently no plans for compulsory redundancies.

Ian Brandwood, from East Lancashire Hospitals NHS Trust, said: "The NHS nationally has been tasked with delivering £20 billion in efficiency savings over the next 3 years. In order to deliver our share of that saving locally, we are exploring all opportunities for further efficiencies and some of those efficiencies will undoubtedly affect the number of people we employ.

"At this stage, our high level forecasts suggest that we will need to reduce the size of our workforce by around 200 people per year between now and 2015. We continue to discuss our plans with our trade unions and remain committed to providing the best possible health care to the people of East Lancashire